Objective To explore the clinical effect of pegylated recombinant human granulocyte stimulat⁃ing factor（PEG⁃rhG⁃CSF）in the prevention of neutropenia after chemotherapy in elderly patients with gastrointesti⁃nal cancer. Methods A total of 47 patients with digestive tract tumors were included in this study. They weregiven a subcutaneous injection of 6 mg PEG⁃rhG⁃CSF on the third day of the first cycle of chemotherapy. If ANCdecreased，they were given subcutaneous injection of 6 mg PEG⁃rhG⁃CSF on the second cycle of chemotherapy. IfANC did not decrease，they were given a subcutaneous injection of 3 mg PEG⁃rhG⁃CSF on the second cycle of che⁃motherapy. Results In the first cycle of chemotherapy，the second cycles of chemotherapy with 3 mg PEG⁃rhG⁃CSFand the second cycles of chemotherapy with 6 mg PEG⁃rhG⁃CSF，the incidence of FN was 19.1%，31.6% and 55.6%（P＜0.05）. There was no significant difference in duration of ANC reduction in the three groups（P > 0.05）. In thefirst cycle of chemotherapy，the second cycles of chemotherapy with 3 mg PEG⁃rhG⁃CSF and the second cycles ofchemotherapy with 6 mg PEG⁃rhG⁃CSF，the incidence of FN was 4.3%，7.9% and 11.1%，which was no significantdifference（P > 0.05）. During the study period，there were 2 cases with bone pain，1 case with asthenia and 1 casewith muscle pain. The total incidence of adverse reactions was 8.5%. Conclusion PEG⁃rhG⁃CSF can effectivelyprevent neutropenia in elderly patients with gastrointestinal cancer，and it has high safety.